Hepatic Veno-occlusive Disease and Renal Transplantation

Excerpt

To the editor: Up to now, 15 cases of hepatic veno-occlusive disease have been reported in recipients of renal transplants treated with azathioprine (1-3). Read and colleagues (1) suggest a direct role of azathioprine in the pathogenesis of this disease. The small number of patients in which this clinicopathologic diagnosis has been established is surprising, however, considering the many thousand of transplant recipients treated with this drug all over the world. Nevertheless, we agree with Read and colleagues that a high index of suspicion is required, especially from the pathologic viewpoint.

Azathioprine and veno-occlusive disease may be only casually related,